Buckle and greenstick fractures
Another type of pediatric fracture is a buckle (or torus) fracture. These fractures are the result of an injury to a bone that’s softer and less calcified than adult bones. Imagine this injury is similar to the motion of forcing two ends of a piece of paper together, causing a crinkling, or buckling of the paper.
Luckily, these buckle fractures are not as painful and they heal quickly with few long-term effects. Often, the only necessary treatment is a cast for three to four weeks.
A variation of a buckle fracture is a greenstick fracture. This, as the name implies, is a fracture of a young bone that is like the bending of a young (still green on the inside) tree limb. Here the bone does not break into two pieces, but it bends remaining intact on the inside and fractures on the outside of the curve.
Although these fractures are called wrist fractures, this is a misleading term as the bone really breaks at the end of the forearm bones near the wrist joint. The bones are called the radius and the ulna. The radius is on the side of the thumb while the ulna is on the side of the pinky. These bones break in one of three ways:
- Both bones break away from the growth plate
- One or both bones break within the growth plate
- One or both bones buckle in a relatively weaker part of the bone
If the bone breaks away from the growth plate, the pieces are often separated far from each other and may need to be put back into place under sedation. Typically, once the pieces are lined up, your child will be placed in a cast that goes above the elbow for a month, and then a shorter cast for several more weeks. At first, weekly office visits may be necessary until the fracture heals enough that the bone won’t move in the cast. Once the casting is done, your child may be prescribed a wrist brace to wear for several weeks for extra support.
If the bone breaks within the growth area, your child’s doctor will line up the bones as straight as possible. While treatment is much like what’s described above, a follow-up visit may be necessary six months after the fracture to ensure the bone is growing normally.